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The Use of Bioelectrical Impedance Analysis Measures for Predicting Clinical Outcomes in Critically Ill Children
Zi-Hong Xiong1,2, Xue-Mei Zheng3, Guo-Ying Zhang1
1Department of Pediatric Intensive Care Unit, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Insights
Bioelectrical impedance analysis (BIA) phase angle (PhA) can predict 90-day mortality in critically ill children. Lower PhA indicates a higher risk of mortality and prolonged mechanical ventilation.
Area of Science:
- Pediatric critical care medicine
- Nutritional assessment
- Biomedical engineering
Background:
- Critically ill children often face nutritional challenges impacting outcomes.
- Bioelectrical impedance analysis (BIA) is a non-invasive method to assess body composition.
- The predictive value of BIA in pediatric intensive care unit (PICU) populations requires further investigation.
Purpose of the Study:
- To evaluate the association between BIA-derived parameters and clinical outcomes in critically ill children.
- To determine if BIA can predict 90-day mortality in this patient group.
- To explore the relationship between BIA measures and ventilation duration.
Main Methods:
- A single-center prospective observational study was conducted in a mixed PICU.
- 231 critically ill children underwent anthropometric and BIA measurements within 24 hours of admission.
- Clinical data, including 90-day mortality and ventilation duration, were collected and analyzed.
Main Results:
- 31.6% of patients were diagnosed with malnutrition.
- Phase angle (PhA) was significantly higher in 90-day survivors compared to non-survivors (4.3° vs. 3.1°, P=0.02).
- PhA was an independent predictor of 90-day mortality (adjusted OR=1.51, P=0.01) with an AUROC of 0.69.
Conclusions:
- BIA-derived PhA is a significant independent predictor of 90-day mortality in critically ill children.
- A lower PhA is associated with increased mortality risk and prolonged mechanical ventilation.
- BIA offers a valuable tool for nutritional assessment and outcome prediction in PICU patients.
Background:
The study aimed to investigate the association of bioelectrical impedance analysis (BIA) for predicting clinical outcomes in critically ill children.
Methods:
This single-center prospective observational study included patients admitted to a mixed Pediatric Intensive Care Unit (PICU). All patients underwent anthropometric measurement and BIA measurements in the first 24 h of admission. The patients were classified into different groups based on body mass index (BMI) for age. Electronic hospital medical records were reviewed to collect clinical data for each patient. All the obtained data were analyzed by the statistical methods.
Results:
There were 231 patients enrolled in our study, of which 31.6% were diagnosed with malnutrition. The phase angle (PhA) of 90-day survivors was significantly higher than that of the non-survivors (4.3° ± 1.1°vs. 3.1° ± 0.9°, P = 0.02). The age-adjusted Spearman partial correlation analysis showed a weak negative correlation between PhA and duration of medical ventilation (rs = -0.42, P < 0.05). Furthermore, length of stay in PICU has a very weak correlation with ECW/TBW (rs = 0.29, P < 0.05), and a negative correlation with protein (rs = -0.27, P < 0.05). Multivariate analysis found that PhA was a significant predictor associated with the 90-day mortality when it was adjusted for PRISM III score (adjusted OR = 1.51, CI: 1.10-2.07, p = 0.01). The area under the ROC (AUROC) of PhA for predicting 90-day mortality was 0.69 (95% CI: 0.53-0.85, p < 0.05), and the cutoff value of PhA was 3.0°, with a sensitivity and specificity of 83 and 53%, respectively.
Conclusion:
BIA-derived PhA was found to be an independent predictor of 90-day mortality among critically ill children. A low PhA was associated with a prolonged duration of medical ventilation.
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